Advance Directive Indiana

Indiana Consolidated Three Documents Into One

Indiana's approach to advance healthcare planning changed significantly through Senate Enrolled Act 204. Effective July 1, 2021, with the transition completed by December 31, 2022, the state retired three separate instruments — the healthcare power of attorney, the appointment of healthcare representative, and the living will declaration. In their place is a single unified document: the Advance Directive for Health Care Decisions under IC § 16-36-7.

This consolidation matters because an Advance Directive now covers everything that previously required three separate forms. It allows the declarant to appoint one or more Health Care Representatives to make medical decisions and access protected health information. It captures end-of-life treatment preferences. And it accommodates anatomical gifts and funeral planning declarations, all within one instrument.

If you are working with documents executed before 2023, they may still reference the old terminology — "healthcare power of attorney" or "living will." These pre-existing documents remain valid, but anyone executing a new healthcare planning document should use the current Advance Directive format.

Execution Requirements Under IC § 16-36-7-28

The execution rules are precise and non-negotiable. The document must be in writing, dated, and signed by the declarant. If the declarant is physically unable to sign, another person may sign on their behalf, but only in the declarant's presence and at their express direction.

Validation requires one of two methods. The first is two adult witnesses who sign in the declarant's presence, with at least one of them being someone other than a spouse or relative of the declarant. The second is a notary public who signs or acknowledges the document and attaches a standard notarial certificate.

These witness requirements differ from the rules for a durable financial power of attorney. The financial POA under IC 30-5-4-1.5 has its own "interested witness" framework tied to whether the witness is a named agent or has a beneficial interest. The Advance Directive witness rule is simpler — at least one witness must not be a spouse or relative — but it is a separate standard. Do not assume that witnesses who satisfy one document's requirements automatically satisfy the other's.

Remote Execution for Separated Families

Indiana recognizes that families are often geographically dispersed when a health crisis strikes. The law permits three remote execution methods for Advance Directives.

First, the declarant and witnesses or notary can interact in real-time through audiovisual technology — essentially a video call where all parties can see and hear each other. Second, the document can be signed in paper counterparts, meaning each party signs their own copy, provided all separately signed counterparts are combined into a single composite document within ten business days of receiving the final signature.

Third, for declarants who cannot use audiovisual technology due to physical impairments or isolation, telephonic witnessing is permitted under specific conditions. The two witnesses must be able to positively identify the declarant, confirm their capacity, and the document must include explicit language stating that telephonic interaction was used. Telephonic notarization, however, is strictly prohibited — only witnesses can participate by phone.

What the Advance Directive Covers

A Health Care Representative appointed through an Advance Directive can make medical treatment decisions when the declarant is unable to communicate their own wishes. This includes consenting to or refusing medical procedures, selecting care facilities, directing end-of-life care, and accessing the declarant's medical records and health information.

The document can also include specific instructions about life-sustaining treatment, artificial nutrition and hydration, pain management preferences, and conditions under which the declarant would or would not want aggressive intervention. These instructions guide both the appointed representative and the treating healthcare providers.

What the Advance Directive does not cover is financial decision-making. It does not authorize the representative to access bank accounts, pay bills, sell property, or apply for Medicaid. Those authorities require a separate Durable Financial Power of Attorney under IC 30-5. Most families caring for an aging parent need both documents.

What Happens Without an Advance Directive

If your parent loses the ability to make healthcare decisions and has not executed an Advance Directive, Indiana defaults to a statutory proxy hierarchy under IC § 16-36-1-5. The order is: judicially appointed guardian, spouse, adult children (majority of those reasonably available), parents, adult siblings, then other relatives.

This hierarchy works in straightforward situations but creates real problems when families are blended, siblings disagree, or the default proxy is not the person best positioned to coordinate care. A properly executed Advance Directive overrides the hierarchy by naming a specific individual with explicit authority.

For families navigating both healthcare and financial planning for an aging parent in Indiana, the Indiana Legal Authority System provides step-by-step guidance on executing both the Advance Directive and the Durable Financial POA, with separate checklists for each document's distinct requirements.

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